Significant ultrasound practice needed to diagnose appendicitis

(HealthDay)—There is a learning curve among novice emergency medicine residents in using emergency ultrasonography to diagnose acute appendicitis, according to a study published online Jan. 5 in the Journal of Clinical Ultrasound.

Jeehyun Kim, M.D., from the Chungnam National University Hospital in Daejon, South Korea, and colleagues compared agreement between the appendicitis diagnoses of three novice emergency medicine residents who completed a one-day training course and an experienced, board-certified radiologist. (Some patients also underwent computed tomography.)

The researchers note that a total of 266 patients were included, and the overall Cohen's kappa coefficient was 0.77. For the first 20 cases, the kappa value was 0.49, but it increased rapidly during this time, and the kappa coefficient was 0.84 after the first 20 cases. The sensitivity and specificity values were 64.3 and 84.4 percent, respectively, for the first 20 cases, but increased to 90.9 and 93.5 percent, respectively, after the first 20 cases.

"A minimum of 20 cases are needed to achieve competency in emergency ultrasonography diagnosis of acute appendicitis," the authors write.